Individual provider Active NPI

Kerin Elizabeth Nagle, APRN

  • Family Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1801366646
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
007963 Issued in CT
Practice address
Community Health Services
500 Albany Ave
Hartford, CT 06120-2508
Phone
(860) 249-9625
NPI assigned
Dec 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F09181069 CT
Family Nurse Practitioner 363LF0000X 007963 CT Primary

Addresses

Primary practice location

Community Health Services
500 Albany Ave
Hartford, CT 06120-2508

Mailing address

500 Albany Ave
Hartford, CT 06120
Phone (860) 462-6764

Other names 1

  • Kerin Elizabeth Gilligan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190130000215 CT Practitioner - Nurse Practitioner 7012254030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians
McLean FundGroup PAC ID 0648247403, 105 clinicians

Practice addresses (Care Compare)

631 Quaker S LN
West Hartford, CT 06110-1026
Phone (860) 231-6130

75 Great Pond Rd
Simsbury, CT 06070-1980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
007963CTMDClinical Social Worker
F09181069CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Family CurrentSince Sep 12, 2022 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

631 S Quaker Ln
West Hartfrd, CT 06110
Phone (860) 231-6130

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: kerin.nagle.npi1801366646.phpct@direct.optumcare.masshiway.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1801366646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06120",
            "telephone_number": "860-462-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COMMUNITY HEALTH SERVICES",
            "address_2": "500 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061202508",
            "telephone_number": "860-249-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGLE",
        "first_name": "KERIN",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "F09181069",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "007963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERIN",
            "last_name": "GILLIGAN",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.